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Florida Ranks Last in Providing Dental Care to Poor Children

More than three-fourths of Florida's children covered by Medicaid do not get regular dental care -- the worst rate of any state, according to a report released today by the Pew Children's Dental Campaign.

More than three-fourths of Florida's children covered by Medicaid do not get regular dental care -- the worst rate of any state, according to a report released today by the Pew Children's Dental Campaign.

The lack of care affected 1.5 million children across the state in 2011, the period analyzed by the Pew researchers. Nationally, they said, tens of millions of low-income children went without dental care that year.

Children whose families had private health insurance were 30 percent more likely to receive dental care than their Medicaid counterparts, the researchers found, even though low-income children -- including those on Medicaid -- are almost twice as likely as their wealthier peers to develop cavities.

"The Florida numbers are horrible, and they don't appear to be getting any better," said Frank Catalanotto, professor and chairman of the Department of Community Dentistry and Behavioral Sciences at the University of Florida College of Dentistry. "The good news to me is that I think some of the people in state are really taking this seriously."

For years, Florida has ranked at or near the bottom in providing dental care to its poorest residents, especially children, a problem that has been linked to increased emergency-room expenses, pain, absence from school and poor grades.

Catalanotto and others contend the main problem is that only 15 percent of Florida dentists accept Medicaid patients -- chiefly because of the state's exceptionally low Medicaid reimbursement rates. Some dentists complain they would actually lose money by treating Medicaid patients.

The other issue, though, is the labyrinth of red tape awaiting dentists who serve Medicaid patients, Catalanotto said. "It takes a long time, there are a lot of forms to fill out, and then you wait and wait and wait."

Because Florida now uses managed-care providers for Medicaid patients, the process includes an additional layer of application and certification. It can take more than six months before dentists can accept Medicaid patients, Catalanotto said.

Members of the Florida Oral Health Workforce Group have been working with state Medicaid administrators to make the process easier for providers. And one benefit of the managed-care providers, Catalanotto said, is that the Affordable Care Act requires them to do public-education campaigns to enroll more patients. Some parents may not realize the importance of early dental care for their children, he said, or that they can sometimes find such care at federally funded health centers in their communities.

The report lauded the growing number of dentists who offer one-day or ongoing charitable care, but researchers said that trend alone would not be enough to solve the problem.

Instead, they suggest not only beefing up Medicaid reimbursement rates and streamlining paperwork, but also employing lower-paid dental-care practitioners -- such as hygienists with special training -- to do some of the more routine treatment now provided by dentists.

The city is the largest in the country that still does not fluoridate it's water supply and the debate over the issue has sharply divided it's usually polite progressives. Citizens will go to the polls to vote on the issue Tuesday.
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